Bitterness as mental illness?

Shari RoanLos Angeles Times Staff Writer

You know them. I know them. And, increasingly, psychiatrists know them. People who feel they have been wronged by someone and are so bitter they can barely function other than to ruminate about their circumstances.

This behavior is so common -- and so deeply destructive -- that some psychiatrists are urging it be identified as a mental illness under the name post-traumatic embitterment disorder. The behavior was discussed before an enthusiastic audience last week at a meeting of the American Psychiatric Assn. in San Francisco.

The disorder is modeled after post-traumatic stress disorder because it too is a response to a trauma that endures. People with PTSD are left fearful and anxious. Embittered people are left seething for revenge.

"They feel the world has treated them unfairly. It's one step more complex than anger. They're angry plus helpless," says Dr. Michael Linden, a German psychiatrist who named the behavior.

Embittered people are typically good people who have worked hard at something important, such as a job, relationship or activity, Linden says. When something unexpectedly awful happens -- they don't get the promotion, their spouse files for divorce or they fail to make the Olympic team -- a profound sense of injustice overtakes them. Instead of dealing with the loss with the help of family and friends, they cannot let go of the feeling of being victimized. Almost immediately after the traumatic event, they become angry, pessimistic, aggressive, hopeless haters.

"Embitterment is a violation of basic beliefs," Linden says. "It causes a very severe emotional reaction. . . . We are always coping with negative life events. It's the reaction that varies."

There are only a handful of studies on the condition, but psychiatrists at the meeting agreed that much more research is needed on identifying and helping these people. One estimate is that 1% to 2% of the population is embittered, says Linden, who has published several studies on the condition.

"These people usually don't come to treatment because 'the world has to change, not me,' " Linden says. "They are almost treatment resistant. . . . Revenge is not a treatment."

Nevertheless, Linden suggests that people once known as loving, normal individuals who suddenly snap and kill their family and themselves may have post-traumatic embitterment syndrome. That's reason enough for researchers to study how to treat the destructive emotion of bitterness.